What is genital herpes?

Genital herpes is very similar to the herpes that appear on the hands and face (‘cold sores’), but is found on or around the penis, anus or vagina.

There are two types of herpes virus, HSV-1 and HSV-2, both can cause genital herpes. The first episode of infection (primary) with genital herpes is often quite severe. There are blisters and inflammation at the site of infection and the sufferer may feel generally unwell. It is common to have symptoms of burning when passing urine.

After the first episode of infection with HSV the virus enters into a dormant phase in the nerve which supplies feeling to the area where infection occurred.

The dormant virus reactivates from time to time to cause recurrences.

Some people get symptoms warning them that a recurrence is about to occur, such as itching, tingling or pain in the genital area; blisters or sores may then develop. These tend to be less severe than the symptoms that occurred at the time of the first episode of infection.

From time to time the virus may reactivate without causing any symptoms of infection at all.

Who gets Genital Herpes

Anyone who has sex can catch genital herpes. The people at most risk are those having unprotected sexual intercourse (i.e. not using condoms), especially those with more than one sexual partner and those who change sexual partners.

In 2004, 18,991 men and women attended STD clinics (also called genitourinary medicine clinics) in United Kingdom with first attack genital herpes.

Rates of diagnosis of genital herpes are highest in 20 to 24 year-old men and women.

How do catch Genital Herpes

Genital herpes is spread by direct contact with the infectious virus. You can catch herpes from somebody with genital herpes via unprotected vaginal or anal sex, genital contact or through oral sex with someone who gets cold sores.

Genital herpes and cold sores are both very infectious when an infected person has blisters or sores.

It is possible for an infected person to transmit the virus when they have no symptoms of infection.

The risk of this happening is probably reduced by using condoms.

How do you know that you have genital herpes?

Genital herpes infection may be asymptomatic in some individuals whereas others have symptoms which can be recurrent in the genital area.

There may be itching, tingling or pain in the genital area, followed by blisters or sores. In women, herpes occurs on the vulva, the vagina, or around the anus or buttocks. In men, genital herpes may occur anywhere around the genitalia or anus.

The signs of genital herpes are not specific in the majority of cases. It is important to have them diagnosed by a doctor.

How serious is Genital Herpes

The majority of people with genital herpes experience mild and infrequent symptoms.

Some people may experience more frequent and severe recurrent episodes.

The risk of transmission from a mother to her baby is greatest for babies born to a woman with first episode genital herpes around the time of delivery. Neonatal herpes is potentially life threatening but occurs very rarely in the UK.

Women with recurrent herpes prior to pregnancy are at very low risk of transmitting the infection to their babies.

How can you protect yourself against genital herpes?

The only way to prevent infection is to avoid direct contact with the virus.

Sexually active men and women reduce their risk of infection by reducing their number of partners and by using condoms correctly and consistently during sexual intercourse.

Avoid having sex with someone who has an active genital herpes sore or an active cold sore as there is high risk of transmission at this time.

How is genital herpes diagnosed?

Diagnosis of genital herpes is often made by taking a swab from the blister or ulcer. It is frequently not possible to make a diagnosis based on the appearance of the herpetic sores as these often vary. A person with their first episode of genital herpes should be tested for other sexually transmitted infections which may be present without symptoms.

Testing for sexually transmitted infections is best done at genitourinary medicine clinics which have the equipment and facilities for testing. The clinics are completely confidential and will not inform GPs unless specifically requested to do so. You can attend one of these clinics at any age (even if you are under the age of consent to sex which is 16).

Some GPs, family planning clinics and young people’s clinics now also offer testing.

How is genital herpes treated?

The first episode of genital herpes is treated with antiviral drugs, which reduce the length and severity of the infection.

Most recurrences are mild and of short duration and do not require any treatment. Antiviral drugs can be used for severe or prolonged recurrences. People with frequent or severe recurrences can have continuous treatment with antiviral drugs to prevent symptoms.

There is no cure for the herpes simplex virus. Infection is lifelong.

If the infection is left untreated, most people will eventually stop having recurrences.

This has been adapted from ‘Sexual Health Birmingham’ the authors are Dr S Acharya & Dr J Arumainayagam.

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